Ontario’s Comprehensive Mental Health and Addictions Strategy
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Presentation by:
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Date
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Ontario’s Comprehensive Mental Health and Addictions Strategy
Purpose of this presentation:
• To provide an overview of results to date of the Comprehensive
Mental Health and Addictions Strategy (Strategy); and
• To engage in discussions regarding opportunities for ongoing
collaboration with Local Health Integration Networks in implementing
the Strategy.
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Ontario’s Comprehensive Mental Health and Addictions Strategy Context
•
In 2006, MCYS released A Shared Responsibility, Ontario’s Policy Framework for
Child and Youth Mental Health (Policy Framework). Its four goals are:
1. A child and youth mental health sector that is coordinated, collaborative
and integrated at all community and government levels, creating a culture
of shared responsibility;
2. Children, youth and their families/caregivers have access to a flexible
continuum of timely and appropriate services and supports within their
own cultural, environmental and community context;
3. Optimal mental health and well-being of children and youth is promoted
through an enhanced understanding of, and ability to respond to, child and
youth mental health needs through the provision of effective services and
supports; and
4. A child and youth mental health sector that is accountable and wellmanaged.
•
•
Following release of the Policy Framework, MCYS and funded child and youth
mental health (CYMH) services completed a ‘mapping’ exercise that took a
“point in time” snapshot of CYMH services in Ontario for the 2007-08 fiscal year.
Mapping showed that there was more to do to build a system in which services
are more responsive, integrated, accountable and focused on what Ontarians
need when they need it.
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Ontario’s Comprehensive Mental Health and Addictions Strategy Context
“One of the criticisms of Ontario’s overall
mental health and addictions system is
that there is, in fact, no coherent
system….Many people simply fall through
the cracks, or give up in frustration
because of the complexity of the system.”
(Select Committee on Mental Health and
Addictions, 2010)
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Ontario’s Comprehensive Mental Health and Addictions Strategy
•
The 2011 Ontario budget announced funding, that by 2013-14 will grow to
$93 million to support a comprehensive Mental Health and Addictions
Strategy, creating a more responsive and integrated system, starting with
children and youth.
Moving “…the system forward rapidly…while
laying the foundation for broader system
changes. Such comprehensive reform of the
child and youth mental health services
system is needed to build an effective,
efficient and accountable system of services.”
(Open Minds, Healthy Minds, 2011)
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Ontario’s Comprehensive Mental Health and Addictions Strategy Priorities
Fast Access to High Quality
Services
Early Identification and
Support
Help for Vulnerable Children
and Youth with Unique
Needs
• Build capacity in the
community-based sector
• Reduce wait times
• Meet community needs
• Link education, child and youth
mental health, youth justice,
health care, and the community
• Provide tools and support to those
in contact with children and youth
so they can identify mental health
issues sooner
• Provide resources for effective
responses to mental health issues
• Build mental health literacy and
local leadership
• Increase availability of
culturally appropriate services
and serve more children and
youth
• in Aboriginal, remote and
underserved communities
• With complex mental
health needs
• At the key transition point
from secondary to postsecondary education
Support System Change
• Support development of an effective and accountable service system for all Ontarians
• Build on efforts that promote evidence-informed practice, collaboration, and efficiencies
• Develop standards and tools to better measure outcomes for children and youth
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A Shared Responsibility Across Sectors
•
•
•
•
Mental health for children and youth is a shared responsibility in Ontario.
The first three years of the Strategy are being led by the Ministry of Children and
Youth Services, in collaboration with the Ministry of Education and the Ministry
of Health and Long-Term Care. The Ministry of Training, Colleges and Universities
is also involved with youth transitioning to postsecondary education.

One sector cannot, and should not do it alone.
Collaboration is needed at all levels - provincial, regional, and individual
communities.
In order to change the system, we need to work together and be willing to
change in order to best serve children and youth.
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Results to Date
There are over 770 new mental health workers across the province including:
• 260 new workers in community child and youth mental health agencies to
provide kids access to services closer to home;
• 144 nurses working with district school boards and local schools to support
the early identification and treatment of students with potential mental
health and/or addiction issues;
• 72 Mental Health Leaders in school boards to provide leadership and
coordination in effective school mental health;
• 21 new workers in the court system to keep youth out of the justice system
and refer them instead to community-based services;
• 19 new full-time Nurse Practitioner positions for pediatric and adult eating
disorders treatment services;
• 175 additional new mental health workers in schools, who will provide kids
support to address their mental health needs; and
• More than 80 new Aboriginal mental health and addictions workers in high
needs communities.
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Results to Date (continued)
Building collaborative capacity on the front lines through:
•
Working Together for Kids’ Mental Health in 11 communities (Niagara, Belleville,
Sudbury, Haliburton, Simcoe, Peel, Frontenac, Lennox/Addington, Lambton,
Ottawa and Hamilton), involving over 300 participating organizations;
•
A pilot peer-support system navigation program for families in selected
communities;
•
Expanded Telepsychiatry for children and youth through the Ontario
Telemedicine Network to increase connectivity to over 1,400 locations;
•
Evidence-based resources and supports to school board administrators and
educators to better understand and effectively support child and youth mental
health and addictions;
•
New and expanded eating disorders treatment services, including inpatient, day
treatment and outpatient programs (pediatric and adult); and
•
Service collaboratives established in 11 communities, bringing together service
providers across sectors to deliver a seamless system of mental health and
addictions services.
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Mental Health in Our Schools
Vision:
•
Ontario’s schools are recognized at home and world-wide as strong academic
organizations that foster and support student well-being
•
Schools are an optimal setting to:






Reduce stigma
Promote positive mental health
Build student social-emotional learning skills
Prevent mental health problems in high risk groups
Identify students in need
Build pathways to care
Key System Priorities:
•
Enhanced Coordination Within and Across Sectors
•
Dedicated Leadership in School Boards
•
Implementation Support
•
Increased Mental Health Awareness and Literacy
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Mental Health in Our Schools (continued)
School Mental Health ASSIST – Provincial Implementation Support Team
• Three areas of focus in Ontario School Boards:
 Organizational Conditions
 Mental Health Awareness, Literacy, Expertise for different groups of school
board staff, based on needs
 Evidence-Based Mental Health Promotion and Prevention Programming in
schools
Key Activities:
• Co-creation of resources with key provincial stakeholder groups for buy-in, support
and effective implementation
• Leadership support and implementation coaching for Mental Health Leaders,
including a Community of Practice (in person and on-line)
• Consultation and Knowledge Exchange
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Mental Health in Postsecondary Institutions
Key Strategies
• To support youth in colleges and universities with a two-pronged approach that
includes:
- a province-wide hotline dedicated to postsecondary students
- a Mental Health Innovation Fund for postsecondary institutions, student
groups and local mental health providers with a postsecondary partner.
Postsecondary Mental Health Hotline
• $2M annually for Kids Help Phone to serve students for general mental
health concerns and issues specific to postsecondary life, such as anxiety
related to admissions/withdrawals, academic performance, residence
living, alienation and loneliness.
• Kids Help Phone is partnering with CONNEX and 211.ca to ensure data is
shared and a “warm transfer” of calls will occur and with the Centre of
Excellence for Child and Youth Mental Health on an evaluation framework.
• Hiring and training of staff has started and a discrete brand is being
developed with the help of students and the postsecondary sector.
• A ‘soft’ launch is planned for the Spring with full implementation for the
start of the school year in September.
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Mental Health in Postsecondary Institutions (continued)
Mental Health Innovation Fund
•
Up to $7M annually for innovative projects with the potential to improve mental
health services and outcomes for Ontario’s postsecondary students.
•
The Ministry has approved 10 projects for funding to date totalling $6.34 million
over three years. Projects range from peer mentoring programs, northern access
initiatives, mental health first aid, and holistic wellness. A second call for proposals
is about to be released.
•
The following universities have received funding: Brock, Laurentian, OCAD
University and Queen’s (2 projects). As well, these colleges have been funded:
Confederation, Humber and Sault. EGALE Canada and Colleges Ontario have also
received funds.
•
Colleges Ontario’s proposal, in partnership with the Council of Universities and
CMHA – Ontario, includes the development of a Centre for Innovation for Campus
Mental Health with three primary functions: support for a community of practice,
a change lab for new innovations, and coordination of community services and
expert advisors.
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Mental Health and Addictions Nurses in Schools
•
•
•
•
Mental Health and Addictions Nurses in schools work as part of an interdisciplinary school team that includes mental health workers, mental health
leaders and other school board staff.
Nurses are providing the support of a health professional to help students (and
families where appropriate) access primary health care, community mental health
and/or addictions services and provide education about options for treatment.
 Students transitioning back to school from a hospital/institution because of a
mental health and/or substance use issue, is a particular focus.
Nurses will continue to build collaborative relationships across sectors and with
existing services and resources to support students with mental health and/or
addictions issues.
MOHLTC is developing an evaluation plan to:
 Ensure the program is being implemented as intended
 Determine whether the program design is suited for its target population
 Provide recommendations for program and quality improvement
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Service Collaboratives
•
•
•
•
Service collaboratives are groups of service providers from diverse sectors working
together to plan and deliver a seamless continuum of mental health and addiction
services in a region or community, based on identified need.
Led by the Centre for Addiction and Mental Health, the first four service
collaboratives have been established and have prioritized their local system gaps:
 Thunder Bay – enhancing community linkages and MHA supports for Dennis
Franklin Cromarty high school students
 Ottawa – continuity of care for high risk youth in service transitions
 Simcoe/Muskoka – coordination of care for transition-aged youth (14-24)
 London – transition from hospital/emergency to community services for youth
with MHA
The second set of service collaboratives has been initiated in Durham, Hamilton,
Frontenac/Kingston, Peel and Waterloo/Wellington and are in the early stages of
development.
The first two justice collaboratives will be established in the Champlain and
Toronto regions, starting in early 2013.
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Strategy Evaluation Framework and Scorecard
•
The Institute for Clinical Evaluative Services (ICES) is leading the development of an
evaluation framework for the Strategy and a mental health and addictions
scorecard, starting with children and youth.
Strategy Evaluation Framework
• The Strategy evaluation framework provides a plan for assessing the Strategy’s
overall impact. Each of the 22 Strategy initiatives are being implemented and
monitored or evaluated by the lead ministries.
• Logic models have been developed to map the inputs, processes, outputs and
expected outcomes of each of the Strategy initiatives, and integrated to develop a
picture of the strategy at a system level.
• Evaluation questions will be confirmed in Spring 2013 to identify specific areas for
study using quantitative and qualitative research methods.
Scorecard
• A Child and Youth Linkable De-identified (ChYLD) data repository is in development
to enable linked data analysis across health, education, children and youth
services, social services and justice sectors.
• ICES has undertaken an extensive Privacy Impact Assessment to ensure that any
development involving data is consistent with privacy and legal requirements.
• Indicators for the scorecard will be finalized in spring 2013, and populated with
baseline data over the coming months.
• Performance measures will be publicly reported as the strategy moves forward.
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We are committed to system change because…
We know, from families, youth, and from
reports over the years, that:
•
The mental health needs of children
and youth are not being met similarly
across the province;
•
Families have difficulty finding their
way to the right service in a timely
way;
•
Cross-sectoral linkages and pathways
are not consistent or robust; and
•
The sector lacks a coherent approach
to standards, performance measures
and accountability.
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Moving on Mental Health – a system that make sense for children and youth
Moving on Mental Health is the next step in transformation of the child and youth
mental health system.
Moving on Mental Health was launched at the Children’s Mental Health Ontario
Conference in November 2012.
We will transform the experience of children and youth with mental health problems
and their families, so that regardless of where they live in Ontario they will know:
 What mental health services are available in their communities; and
 How to access mental health services and supports that meet their needs.
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We will accomplish this system change by:
 Creating and supporting pathways to care – there will be clear and
streamlined pathways to care between primary care, schools and the
supports that children and youth need
 Defining core services – we will identify the core community-based CYMH
services for which MCYS funded lead agencies will be responsible for
ensuring are available to children and youth in their communities
 Establishing lead agencies in every community – there will be a visible,
accountable entity in each community, responsible for ensuring the delivery
of core services
 Developing a transparent, equitable funding model – we will develop a
funding model that is fair, transparent and responsive to community needs
 Putting in place appropriate legislative/regulatory/ accountability tools
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Looking Ahead to 2015
Transformed Child and Youth Mental Health Services
CURRENT STATE
Fragmented,
inefficient, hard to
access, providercentric
Services not
consistently
matched to needs
Many providers;
uneven access
to equitable
service
Lengthy wait
times
Duplication
and silos
Cannot
demonstrate
results
Historical
funding
distribution
FUTURE STATE
Child and youth centred,
responsive, flexible, seamless,
equitable, evidence-informed and
matched to needs
Acceptable
Accessible
Efficient
Coordinated
Collaborative
Effective
Sustainable
What It will look like
•
Parents, children and youth know how to
access services, what is available to them,
and what to expect at each point along
transparent service pathways.
•
Regardless of where they live, families have
access to a consistent set of easy to identify
supports and services through an identifiable
lead agency that is accountable to
government.
•
Coordination
between
providers and
across sectors
Parents, children and youth have confidence
in the people and agencies providing services.
•
Linked standards
contracting,
performance and
results
Wait times for service are timely, predictable,
and matched to severity of need.
•
Parents and funders know whether the
services received have made a difference.
Valid tools,
evidenceinformed practice
Defined
communities, lead
agencies, and core
services
Pathways/needs
and timeliness
at centre of
service delivery
Funding tied to
population,
needs, and
performance
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Appendix - Overview of the Three Year Plan
Starting with Child and Youth Mental Health
INDICATORS
THEMES
Our Vision:
An Ontario in which children and youth mental health is recognized as a key determinant of overall health and well-being, and where
children and youth reach their full potential.
Provide fast access to high quality
service
Early identification and support
Help for vulnerable children and youth with
unique needs
Children, youth and families will know where to go to
get what they need and services will be available to
respond in a timely way.
Professionals in community-based child and youth
mental health agencies and teachers will learn how to
identify and respond to the mental health needs of kids.
Children and youth will receive the type of specialized
service they need and it will be culturally appropriate
• Fewer hospital (ER) admissions and
readmissions for child and youth mental
health
• Higher graduation rates
• Reduced Wait Times
INITIATIVES
Improve public access to
service information
Pilot Family Support
Navigator model
Funding to increase supply
of child and youth mental
health professionals
Increase Youth Mental
Health Court Workers
Reduce wait times for service,
revise service contracting,
standards, and reporting
Outcomes, indicators and
development of scorecard
• Reduced child and youth suicides/suicide
attempts
• Educational progress (EQAO)
• Fewer school suspensions and/or
expulsions
• Higher parent satisfaction in services
received
Implement Working
Together for Kids’ Mental
Health
Amend education curriculum
to cover mental health
promotion and address
stigma
Implement standardized
tools for outcomes and
needs assessment
Develop K-12 resource
guide for educators
•
•
•
More professionals trained to identify
kids’ mental health needs
Decrease in severity of mental health
issues through treatment
Decrease in inpatient admission rates
for child and youth mental health
Enhance and expand
Telepsychiatry model and
services
Hire new Aboriginal workers
Implement Aboriginal Mental
Health Worker Training Program
Provide support at key
transition points
Improve service
coordination for high needs
kids, youth and families
Implement school mental
health ASSIST program and
mental health literacy
provincially
Provide designated mental
health workers in schools
Expand inpatient/outpatient
services for child and youth
eating disorders
Hire Nurse Practitioners for
eating disorders program
[part of New Nurses
Initiative]
Implement Mental Health
Leaders in selected School
Boards
Provide nurses in schools to
support mental health services
[part of New Nurses Initiative]
Create 18 service
collaboratives
Plan Evaluation
Ontario’s Comprehensive Mental
Health and Addictions Strategy
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